Provider Demographics
NPI:1598291536
Name:DAVIS, DEBORAH (LCDC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9112 SPRING BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-7454
Mailing Address - Country:US
Mailing Address - Phone:903-830-0056
Mailing Address - Fax:
Practice Address - Street 1:9112 SPRING BRANCH DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-7454
Practice Address - Country:US
Practice Address - Phone:903-830-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)